collection
https://read.qxmd.com/read/26514398/differences-in-preductal-and-postductal-arterial-blood-gas-measurements-in-infants-with-severe-congenital-diaphragmatic-hernia
#21
JOURNAL ARTICLE
Jason Gien, John P Kinsella
OBJECTIVE: To determine whether right-to-left shunting across the ductus arteriosus (DA) in patients with congenital diaphragmatic hernia (CDH) with suprasystemic pulmonary hypertension (PH) results in differences between preductal and postductal arterial blood gas (ABG) measurements. DESIGN: Demographics, baseline echocardiographic parameters and differences in simultaneous right upper extremity (preductal) and umbilical artery (postductal) ABG samples were determined in newborns with PH and CDH...
July 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://read.qxmd.com/read/27376883/improved-pulmonary-function-in-the-nitrofen-model-of-congenital-diaphragmatic-hernia-following-prenatal-maternal-dexamethasone-and-or-sildenafil
#22
JOURNAL ARTICLE
Carmen Mesas Burgos, Erik G Pearson, Marcus Davey, John Riley, Huimin Jia, Pablo Laje, Alan W Flake, William H Peranteau
BACKGROUND: Pulmonary hypoplasia and hypertension is a leading cause of morbidity and mortality in congenital diaphragmatic hernia (CDH). The etiologic insult occurs early in gestation highlighting the potential of prenatal interventions. We evaluated prenatal pharmacologic therapies in the nitrofen CDH model. METHODS: Olive oil or nitrofen were administered alone or with dexamethasone (DM), sildenafil, or DM+sildenafil to pregnant rats. Newborn pups were assessed for lung function, structure and pulmonary artery (PA) flow and resistance...
October 2016: Pediatric Research
https://read.qxmd.com/read/27339082/a-modern-era-comparison-of-right-versus-left-sided-congenital-diaphragmatic-hernia-outcomes
#23
COMPARATIVE STUDY
Michael Collin, Sarah Trinder, Corrado Minutillo, Shripada Rao, Jan Dickinson, Naeem Samnakay
BACKGROUND/PURPOSE: This study aims to retrospectively review outcomes, including neurodevelopmental outcomes, of neonatal right sided congenital diaphragmatic hernias (RCDH) compared with left sided congenital diaphragmatic hernias (L-CDH) treated surgically at our institute. METHODS: A retrospective review was undertaken of all cases of congenital diaphragmatic hernia (CDH) treated at Princess Margaret Hospital for Children (PMH), Perth, born between 1st January 2002 and 1st August 2012...
September 2016: Journal of Pediatric Surgery
https://read.qxmd.com/read/27342009/right-versus-left-sided-congenital-diaphragmatic-hernia-a-comparative-outcomes-analysis
#24
JOURNAL ARTICLE
Emily A Partridge, William H Peranteau, Lisa Herkert, Norma Rendon, Haylee Smith, Natalie E Rintoul, Alan W Flake, N Scott Adzick, Holly L Hedrick
PURPOSE: Right-sided congenital diaphragmatic hernia (R-CDH) occurs in up to 25% of all CDH cases, but has been less widely studied compared to left-sided defects. We sought to compare characteristics and outcomes of left- versus right-sided defects in a large cohort of CDH patients who underwent standardized treatment and follow-up at a single institution. METHODS: We retrospectively reviewed charts of all CDH patients in our pulmonary hypoplasia program from January 2002 through December 2014...
June 2016: Journal of Pediatric Surgery
https://read.qxmd.com/read/18280293/redefining-outcomes-in-right-congenital-diaphragmatic-hernia
#25
JOURNAL ARTICLE
Jason C Fisher, Rashida A Jefferson, Marc S Arkovitz, Charles J H Stolar
PURPOSE: Available data comparing the management and outcome of right-sided (R-CDH) vs left-sided congenital diaphragmatic hernia (L-CDH) are inconsistent. Large-volume CDH studies are limited by small numbers of R-CDH or are confounded by compilations from multiple institutions with multiple treatment strategies. Consequently, they are underpowered to draw conclusions. To define the behavior and outcomes of R-CDH better, we report the largest single-institution series of R-CDH and ask if factors traditionally linked to poor prognosis in L-CDH were applicable to R-CDH...
February 2008: Journal of Pediatric Surgery
https://read.qxmd.com/read/25597867/severe-left-diaphragmatic-hernia-limits-size-of-fetal-left-heart-more-than-does-right-diaphragmatic-hernia
#26
JOURNAL ARTICLE
F A Byrne, R L Keller, J Meadows, D Miniati, M M Brook, N H Silverman, A J Moon-Grady
OBJECTIVES: To assess whether severity of congenital diaphragmatic hernia (CDH) correlates with the degree of left heart hypoplasia and left ventricle (LV) output, and to determine if factors leading to abnormal fetal hemodynamics, such as compression and reduced LV preload, contribute to left heart hypoplasia. METHODS: This was a retrospective cross-sectional study of fetuses at 16-37 weeks' gestation that were diagnosed with CDH between 2000 and 2010. Lung-to-head ratio (LHR), liver position and side of the hernia were determined from stored ultrasound images...
December 2015: Ultrasound in Obstetrics & Gynecology
https://read.qxmd.com/read/23331808/lung-to-head-ratio-in-infants-with-congenital-diaphragmatic-hernia-does-not-predict-long-term-pulmonary-hypertension
#27
JOURNAL ARTICLE
Alejandro V Garcia, Abbey L Fingeret, Arul S Thirumoorthi, Eunice Hahn, Matthew J Leskowitz, Gudrun Aspelund, Usha S Krishnan, Charles J H Stolar
PURPOSE: Lung-to-head ratio (LHR) has been used for antenatal evaluation of infants with congenital diaphragmatic hernia (CDH). We hypothesized that LHR was predictive of acute and chronic pulmonary hypertension in infants with CDH. METHODS: Echocardiograms on all inborn infants with CDH (December 2001-March 2011) were reviewed. Echocardiograms at 1 and 3 months post-repair and most recent follow-up were assessed for presence of pulmonary hypertension (PAH). LHR, gestational age, birth weight, extracorporeal membrane oxygenation (ECMO), and death rate were obtained...
January 2013: Journal of Pediatric Surgery
https://read.qxmd.com/read/23375362/outcomes-of-congenital-diaphragmatic-hernia-in-the-modern-era-of-management
#28
MULTICENTER STUDY
Julia Wynn, Usha Krishnan, Gudrun Aspelund, Yuan Zhang, Jimmy Duong, Charles J H Stolar, Eunice Hahn, John Pietsch, Dai Chung, Donald Moore, Eric Austin, George Mychaliska, Robert Gajarski, Yen-Lim Foong, Erik Michelfelder, Douglas Potolka, Brian Bucher, Brad Warner, Mark Grady, Ken Azarow, Scott E Fletcher, Shelby Kutty, Jeff Delaney, Timothy Crombleholme, Erika Rosenzweig, Wendy Chung, Marc S Arkovitz
OBJECTIVE: To identify clinical factors associated with pulmonary hypertension (PH) and mortality in patients with congenital diaphragmatic hernia (CDH). STUDY DESIGN: A prospective cohort of neonates with a diaphragm defect identified at 1 of 7 collaborating medical centers was studied. Echocardiograms were performed at 1 month and 3 months of age and analyzed at a central core by 2 cardiologists independently. Degree of PH and survival were tested for association with clinical variables using Fischer exact test, χ(2), and regression analysis...
July 2013: Journal of Pediatrics
https://read.qxmd.com/read/21815746/prenatal-lung-head-ratio-threshold-to-predict-outcome-for-congenital-diaphragmatic-hernia
#29
JOURNAL ARTICLE
Gudrun Aspelund, Jason C Fisher, Lynn L Simpson, Charles J H Stolar
OBJECTIVE: The literature suggests that lung-head ratio (LHR) and liver position may inconsistently predict outcome for congenital diaphragmatic hernia (CDH). We reviewed our inborn neonates with isolated left-sided CDH to determine whether these variables predicted survival and to estimate the optimal LHR threshold. METHODS: Prenatal LHR and liver position were obtained from 2002 to 2009. The primary endpoint was survival. RESULTS: LHR was greater in survivors after adjusting for gestational age (median 1...
July 2012: Journal of Maternal-fetal & Neonatal Medicine
https://read.qxmd.com/read/21763826/early-recurrence-of-congenital-diaphragmatic-hernia-is-higher-after-thoracoscopic-than-open-repair-a-single-institutional-study
#30
COMPARATIVE STUDY
Jeffrey W Gander, Jason C Fisher, Erica R Gross, Ari R Reichstein, Robert A Cowles, Gudrun Aspelund, Charles J H Stolar, Keith A Kuenzler
INTRODUCTION: Experience in thoracoscopic congenital diaphragmatic hernia (CDH) repair has expanded, yet efficacy equal to that of open repair has not been demonstrated. In spite of reports suggesting higher recurrent hernia rates after thoracoscopic repair, this approach has widely been adopted into practice. We report a large, single institutional experience with thoracoscopic CDH repair with special attention to recurrent hernia rates. METHODS: We reviewed the records of neonates with unilateral CDH repaired between January 2006 and February 2010 at Morgan Stanley Children's Hospital...
July 2011: Journal of Pediatric Surgery
https://read.qxmd.com/read/17011276/lung-function-in-infants-after-repair-of-congenital-diaphragmatic-hernia
#31
JOURNAL ARTICLE
Anastassios C Koumbourlis, Jen Tien Wung, Charles J Stolar
BACKGROUND/PURPOSE: Congenital diaphragmatic hernia (CDH) is initially characterized by severe restrictive lung defect and low lung compliance, but survivors have relatively few abnormalities later in life. We studied the changes in lung growth and function in infants after the repair of CDH. METHODS: Retrospective analysis of pulmonary function tests was performed during the first 24 months of life in 56 infants (33 male and 23 female) after repair of CDH. Lung function (functional residual capacity [FRC], respiratory system compliance [C(rs)] and resistance [R(rs)], and maximum expiratory flow rate at FRC [V'(maxFRC)]) were compared among 4 different ages (0-3, 4-6, 7-12, and 13-24 months)...
October 2006: Journal of Pediatric Surgery
https://read.qxmd.com/read/17637787/congenital-diaphragmatic-hernia-a-systematic-review-and-summary-of-best-evidence-practice-strategies
#32
REVIEW
J W Logan, H E Rice, R N Goldberg, C M Cotten
OBJECTIVES: Recent reports suggest that specific care strategies improve survival of infants with congenital diaphragmatic hernia (CDH). This review presents details of care from centers reporting high rates of survival among CDH infants. STUDY DESIGN: We conducted a MEDLINE search (1995 to 2006) and searched all citations in the Cochrane Central Register of Controlled Trials. Studies were included if they contained reports of >20 infants with symptomatic CDH, and >75% survival of isolated CDH...
September 2007: Journal of Perinatology: Official Journal of the California Perinatal Association
https://read.qxmd.com/read/11877648/congenital-diaphragmatic-hernia-in-120-infants-treated-consecutively-with-permissive-hypercapnea-spontaneous-respiration-elective-repair
#33
COMPARATIVE STUDY
Judd Boloker, David A Bateman, Jen-Tien Wung, Charles J h Stolar
BACKGROUND/PURPOSE: Poor prognosis (approximately 50% survival rate and significant morbidity) traditionally has been associated with congenital diaphragmatic hernia (CDH). The authors reviewed a single institution experience and challenged conventional wisdom in the context of a care strategy based on permissive hypercapnea/spontaneous respiration/elective repair. METHODS: From August 1992 through February 2000, all infants with CDH and (1) respiratory distress requiring mechanical ventilation, (2) in-born or (3) transferred preoperatively within hours of birth are reported...
March 2002: Journal of Pediatric Surgery
https://read.qxmd.com/read/20105618/hepatic-pulmonary-fusion-in-an-infant-with-a-right-sided-congenital-diaphragmatic-hernia-and-contralateral-mediastinal-shift
#34
JOURNAL ARTICLE
Jeffrey W Gander, Angela Kadenhe-Chiweshe, Jason C Fisher, Brooke S Lampl, Walter E Berdon, Charles J Stolar, Jeffrey L Zitsman
Hepatic pulmonary fusion is extremely rare with only 9 previous cases reported in the literature. In typical cases, the clinician should be alerted to the possibility of hepatic pulmonary fusion if the chest radiograph shows a large opacity on the right side without a contralateral mediastinal shift. The authors present a case of right-sided diaphragmatic hernia and hepatic pulmonary fusion with associated contralateral mediastinal shift discovered beyond the neonatal period. The 9 previous cases were retrospectively reviewed with special attention to mediastinal shift on preoperative chest radiograph, operative procedure, and mortality...
January 2010: Journal of Pediatric Surgery
https://read.qxmd.com/read/22595714/congenital-diaphragmatic-hernia-and-protective-ventilation-strategies-in-pediatric-surgery
#35
REVIEW
Alejandro Garcia, Charles J H Stolar
Infants affected with congenital diaphragmatic hernias (CDH) suffer from some degree of respiratory insufficiency arising from a combination of pulmonary hypoplasia and pulmonary hypertension. Respiratory care strategies to optimize blood gasses lead to significant barotrauma, increased morbidity, and overuse of extracorporeal membrane oxygenation (ECMO). Newer permissive hypercapnia/spontaneous ventilation protocols geared to accept moderate hypercapnia at lower peak airway pressures have led to improved outcomes...
June 2012: Surgical Clinics of North America
https://read.qxmd.com/read/27077664/standardized-postnatal-management-of-infants-with-congenital-diaphragmatic-hernia-in-europe-the-cdh-euro-consortium-consensus-2015-update
#36
JOURNAL ARTICLE
Kitty G Snoek, Irwin K M Reiss, Anne Greenough, Irma Capolupo, Berndt Urlesberger, Lucas Wessel, Laurent Storme, Jan Deprest, Thomas Schaible, Arno van Heijst, Dick Tibboel
In 2010, the congenital diaphragmatic hernia (CDH) EURO Consortium published a standardized neonatal treatment protocol. Five years later, the number of participating centers has been raised from 13 to 22. In this article the relevant literature is updated, and consensus has been reached between the members of the CDH EURO Consortium. Key updated recommendations are: (1) planned delivery after a gestational age of 39 weeks in a high-volume tertiary center; (2) neuromuscular blocking agents to be avoided during initial treatment in the delivery room; (3) adapt treatment to reach a preductal saturation of between 80 and 95% and postductal saturation >70%; (4) target PaCO2 to be between 50 and 70 mm Hg; (5) conventional mechanical ventilation to be the optimal initial ventilation strategy, and (6) intravenous sildenafil to be considered in CDH patients with severe pulmonary hypertension...
2016: Neonatology
https://read.qxmd.com/read/26995524/space-occupying-lesions-in-the-presence-of-congenital-diaphragmatic-hernia
#37
JOURNAL ARTICLE
Stephanie M Cruz, Adesola C Akinkuotu, Darrell L Cass, Timothy C Lee, Christopher I Cassady, Amy R Mehollin-Ray, Rodrigo Ruano, Stephen E Welty, Oluyinka O Olutoye
INTRODUCTION: Previous reports describe lung malformations and other chest lesions in association with congenital diaphragmatic hernia (CDH), yet little is known how these lesions affect outcomes. We sought to evaluate the incidence and outcomes of patients diagnosed with chest lesions in association with CDH. METHODS: The charts of all infants treated for CDH in a single tertiary center from January 2004 to January 2015 were reviewed. The outcomes of those with space occupying lesions (SOLs) in association with CDH were compared to those with isolated CDH...
May 2016: Journal of Pediatric Surgery
https://read.qxmd.com/read/26987711/an-evaluation-of-the-role-of-concomitant-anomalies-on-the-outcomes-of-fetuses-with-congenital-diaphragmatic-hernia
#38
JOURNAL ARTICLE
Adesola C Akinkuotu, Stephanie M Cruz, Darrell L Cass, Timothy C Lee, Christopher I Cassady, Amy R Mehollin-Ray, Rodrigo Ruano, Stephen E Welty, Oluyinka O Olutoye
PURPOSE: The purpose of this study was to evaluate the impact of various types of associated anomalies on CDH mortality and morbidity. METHODS: All CDH patients at a tertiary care center from January 2004 to January 2014 were reviewed retrospectively. Isolated CDH was defined as CDH without any associated anomalies. Cardiac anomalies were stratified into minor and major based on the Risk Adjustment for Congenital Heart Surgery-1 (RACHS-1) scoring system. Other anatomic anomalies requiring intervention in the perinatal period were classified as major anomalies...
May 2016: Journal of Pediatric Surgery
https://read.qxmd.com/read/26963428/predicting-death-or-extended-length-of-stay-in-infants-with-congenital-diaphragmatic-hernia
#39
MULTICENTER STUDY
K Murthy, E K Pallotto, J Gien, B S Brozanski, N F M Porta, I Zaniletti, S Keene, L G Chicoine, N E Rintoul, F D Dykes, J M Asselin, B L Short, M A Padula, D J Durand, K M Reber, J R Evans, T R Grover
OBJECTIVE: To predict mortality or length of stay (LOS) >109 days (90th percentile) among infants with congenital diaphragmatic hernia (CDH). STUDY DESIGN: We conducted a retrospective analysis using the Children's Hospital Neonatal Database during 2010 to 2014. Infants born >34 weeks gestation with CDH admitted at 22 participating regional neonatal intensive care units were included; patients who were repaired or were at home before admission were excluded...
August 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://read.qxmd.com/read/23701760/stability-prior-to-surgery-in-congenital-diaphragmatic-hernia-is-it-necessary
#40
JOURNAL ARTICLE
Alana L Beres, Pramod S Puligandla, Mary E Brindle
BACKGROUND: Delaying surgery for infants with CDH until they achieve clinical stability is common practice. Stability, however, is inconsistently defined, and many infants fail to reach pre-established criteria. We sought to determine if infants undergoing surgery without meeting pre-established criteria could achieve meaningful survival. METHODS: All infants in the CAPSNet database were analyzed (2005-2010). Patients undergoing operative repair were divided into two groups based on whether they met strict (FiO2<0...
May 2013: Journal of Pediatric Surgery
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